Transcend program in Newport News offers community living for the mentally ill

Program is an alternative for those from Eastern State

A dozen men and women in the Transcend program in Newport News are demonstrating how community housing can work for those with a serious mental illness.

"I love it. It's a wide-about mansion," said Karen Spangler, who was the first to join the program, in March 2012, after 26 years as a resident of Eastern State Hospital in James City County. Spangler had just returned from an outing with staff to Sandy Bottom Nature Park in Hampton. "There wasn't anything else to do at the hospital," she said.

As the number of psychiatric beds at Eastern State has been slashed since 2010, the push to integrate those with mental illnesses into community settings has been stalled for lack of housing options and community support. The result has been a backlog of Eastern State residents who are "discharge ready" but have nowhere to go; this in turn has created a problem for those in the community who are in need of crisis care because Eastern State has no room for them.

The Transcend program, the only one of its kind in the region, is providing an option — all 12 residents are former long-term Eastern State patients.

The hospital has more residents waiting for community placement. More than 10 percent of the facility's 300-person census — 32 patients — have been cleared for discharge, but are on the "extraordinary barriers list," according to Meghan McGuire, a spokeswoman for the Virginia Department of Behavioral Health and Developmental Services.

"These include NGRI (not guilty by reason of insanity) individuals who are waiting on the court system, geriatric patients with a multitude of physical health needs and other barriers," she wrote in an email.

The cost of community care is a fraction of the cost of hospital care.

Chuck Hall, director of the Hampton-Newport News Community Services Board, which runs the program, said caring for a Transcend resident costs $285 a day, including round-the-clock supervision, psychiatric care and medication management. At Eastern State, the daily cost per person is $660, or $242,000 a year.

The home has a staff of 17, most part-time, but all with mental health training. Much of their work involves training residents in social skills and "activities of daily living," such as cleaning, cooking, laundry and self-care. Each counselor works with three residents.

The biggest transition from hospital life is learning to become more active, said Tiffany Graham, residential services supervisor.

"They were allowed to lay around all day. In the beginning I have to explain that this is their home. Eventually they buy into it," she said. Residents are responsible for keeping their rooms in order, as well as cooking and menu planning for the group.

Transcend, which now draws patients from Virginia Beach to Williamsburg, started in 2012 with two residents in a rented apartment.

It moved to its current location last April, a residence that formerly was a home for the developmentally delayed, and reached capacity in August. It has individual bedrooms, handicapped-accessible bathrooms, and a functional layout for group living that includes common areas, a central kitchen and large dining area. There are few frills — linoleum floors and no pictures on the walls — but all residents have their own rooms and furnishings along with a choice of colors in accessories.

The house is set on the edge of a residential neighborhood, behind a locked wire perimeter fence. Residents are free to wander the spacious yard at will.

"This is their home. If they want to be up at 2 a.m. and be outside to smoke, that's OK. There's no curfew," said Bob Deisch, CSB program administrator.

All suffer from a serious mental illness, such as schizophrenia, bipolar disorder or schizo-affective disorder, but have been deemed stable over time.

"Patients must be identified by their treatment team as having met their treatment goals and are no longer in need of hospital level care," wrote Maria Reppas, a spokeswoman for the health department and Eastern State. Many attend all-day support programs by choice, but others opt to stay at the house and participate in daily outings, such as going to the park and shopping. Others volunteer for kitchen duty.

Though the hope is that some may "graduate" to more independent living, it's designed as a permanent home.

"It's not transitional. There's no time frame," said Deisch.

Residents tap into a variety of resources — Medicare, Medicaid, Social Security Disability Insurance — and pay up to 30 percent of their income in rent. Other financing comes from grant funds from the state.

The home is leased from the Newport News Housing and Redevelopment Authority and has a Section 8 certificate that covers all occupants, rather than residents having to apply individually.

"They wouldn't all qualify. Some have criminal backgrounds," said Graham. The residents have to meet certain conditions and sign a lease, which gives them a crucial tenant history if they want to move on elsewhere, she said.